Shallotte Chiropractic Balance and Wellness PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SHALLOTTE CHIROPRACTIC BALANCE AND WELLNESS PLLC

Practice address

4465 Main St
Shallotte, NC 28470-4451

Phone

(910) 505-8680

Fax

(910) 612-6002

NPI assigned

Jan 20, 2023

Last updated

Dec 28, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Agnes Regina Freeman, DCNPI 1083616825

Title

Owner/President

Phone

(910) 264-1705

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Agnes Regina Freeman, D.C

  • Chiropractor
  • Whiteville, NC
  • NPI 1083616825
  Medicare reassignment NPD Authorized official
• Pamela F. Baldwin, D.C.

  • Chiropractor
  • Whiteville, NC
  • NPI 1902856495
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1609581933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 MAIN ST",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704451",
            "telephone_number": "910-505-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 MAIN ST",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704451",
            "telephone_number": "910-505-8680",
            "fax_number": "910-612-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALLOTTE CHIROPRACTIC BALANCE AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "AGNES",
        "authorized_official_middle_name": "REGINA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "910-264-1705",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89085H6",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1083616825",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "085H6",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seaside Psychological Assessments and Resources for Kids PLLC (SPARKids)
• Karla Melissa Sebastian, OTR/L
• Britton Seivert, LPC LCMHCA
• Haley Sellers, BSN RN IBCLC
• Samantha Sessoms, LCASA
• Shallotte Chiropractic PLLC
• Shallotte Medical Center Inc
• Shallotte Urgent Care PA
• Shallotte Volunteer Rescue Squad
• Chelsea Shaw, LCSWA

• Chiropractor in Shallotte, NC
• Providers in Shallotte, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.